Description logic-based methods for auditing frame-based medical terminological systems

Objective: Medical terminological systems (TSs) play an increasingly important role in health care by supporting recording, retrieval and analysis of patient information. As the size and complexity of TSs are growing, the need arises for means to audit them, i.e. verify and maintain (logical) consistency and (semantic) correctness of their contents. This is not only important for the management of TSs but also for providing their users with confidence about the reliability of their contents. Formal methods have the potential to play an important role in the audit of TSs, although there are few empirical studies to assess the benefits of using these methods. Methods and material: In this paper we propose a method based on description logics (DLs) for the audit of TSs. This method is based on the migration of the medical TS from a frame-based representation to a DL-based one. Our method is characterized by a process in which initially stringent assumptions are made about concept definitions. The assumptions allow the detection of concepts and relations that might comprise a source of logical inconsistency. If the assumptions hold then definitions are to be altered to eliminate the inconsistency, otherwise the assumptions are revised. Results: In order to demonstrate the utility of the approach in a real-world case study we audit a TS in the intensive care domain and discuss decisions pertaining to building DL-based representations. This case study demonstrates that certain types of inconsistencies can indeed be detected by applying the method to a medical terminological system. Conclusion: The added value of the method described in this paper is that it provides a means to evaluate the compliance to a number of common modeling principles in a formal manner. The proposed method reveals potential modeling inconsistencies, helping to audit and (if possible) improve the medical TS. In this way, it contributes to providing confidence in the contents of the terminological system. (c) 2005 Elsevier B.V. All rights reserved.